The Use of Preserved Autogenous Septal Cartilage in "Touch-up" Rhinoplasty

Wong, Brian J. F.; Giammanco, Pierre F.

doi:10.1001/archfaci.5.4.349

Cited by 6 publications

(2 citation statements)

References 26 publications

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“…Regardless, the behavior of cartilage following any physical modification process is unpredictable, and even measures such as morselization and carving can produce chondrocyte death. 37 Hence, even standard surgical approaches may significantly traumatize the tissue and compromise cell viability. Figure 12.…”

Section: Commentmentioning

confidence: 99%

Long-term Viability and Mechanical Behavior Following Laser Cartilage Reshaping

Karam

Protsenko

et al. 2006

Archives of Facial Plastic Surgery

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To investigate the long-term in vivo effect of laser dosimetry on rabbit septal cartilage integrity, viability, and mechanical behavior. Methods: Nasal septal cartilage specimens (control and irradiated pairs) were harvested from 18 rabbits. Specimens were mechanically deformed and irradiated with an Nd:YAG laser across a broad dosimetry range (4-8 W and 6-16 seconds). Treated specimens and controls were autologously implanted into a subperichondrial auricular pocket. Specimens were harvested an average±SD of 208±35 days later. Tissue integrity, histology, chondrocyte viability, and mechanical property evaluations were performed. Tissue damage results were compared with Monte Carlo simulation models. Results: All laser-irradiated specimens demonstrated variable tissue resorption and calcification, which increased with increased dosimetry. Elastic moduli of the specimens were significantly either lower or higher than controls (all PϽ.05). Viability assays illustrated a total loss of viable chondrocytes within the laser-irradiated zones in all treated specimens. Histologic examination confirmed these findings. Experimental results were consistent with damage profiles determined using numerical simulations. Conclusion: The loss of structural integrity and chondrocyte viability observed across a broad dosimetry range underscores the importance of spatially selective heating methods prior to initiating application in human subjects.

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Section: Commentmentioning

confidence: 99%

Long-term Viability and Mechanical Behavior Following Laser Cartilage Reshaping

Karam

Protsenko

et al. 2006

Archives of Facial Plastic Surgery

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“…However, infection and extrusion rates are higher with alloplastic materials than with autologous materials. 3,4 To avoid the undesirable effects of allograft materials, such as intolerance, granulomas, graft edge visualization, and implant migration, a new technique using Permacol (porcine dermal collagen sheet; Tissue Science Laboratories plc, Aldershot, United Kingdom) is proposed for dorsal augmentation in oriental noses.…”

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Clinical Effectiveness and Safety of Collagen Sheet for Dorsal Augmentation in Rhinoplasty

Chang

Kong²

2014

Journal of Craniofacial Surgery

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In Asian rhinoplasty, dorsal augmentation often requires the use of alloplastic materials because sufficient amounts of autograft are difficult to harvest. Given considerations of aesthetics, costs, and the characteristics of the oriental nose, silicone or Gore-Tex is commonly used when augmenting the nasal dorsum to a great extent. Such materials can often result in postoperative complications and foreign-body sensations. Moreover, extrusion or visualization of the implant may occur because of thinning of the skin over time. Permacol collagen implants are specifically indicated for soft tissue reinforcement and repair of the head and face in plastic and reconstructive surgery. The handling versatility of the flexible collagen sheet allows it to be layered over itself until the requisite thickness and desired shape are obtained. A total of 50 patients who underwent nasal augmentation rhinoplasty between December 2007 and May 2011 were observed for at least 24 months. Depending on the nasal dorsum, we layered the collagen sheet up to a maximum of 4 times and we have not seen any case of severe resorption or overcorrection in the nasal configuration. Collagen implant material is safe for use in select rhinoplasty patients because of its low complication rate, as shown in our series. It could therefore be considered as a useful alternative when reconstruction is problematic because of the low quality or lack of available autologous grafts.

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